Subdural empyema differential diagnosis: Difference between revisions

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==Overview==
==Overview==
Subdural empyema, also referred to as [[subdural abscess]], [[pachymeningitis interna]] and [[circumscript meningitis]], is a life-threatening [[infection]].<ref name="AgrawalTimothy2007">{{cite journal|last1=Agrawal|first1=Amit|last2=Timothy|first2=Jake|last3=Pandit|first3=Lekha|last4=Shetty|first4=Lathika|last5=Shetty|first5=J.P.|title=A Review of Subdural Empyema and Its Management|journal=Infectious Diseases in Clinical Practice|volume=15|issue=3|year=2007|pages=149–153|issn=1056-9103|doi=10.1097/01.idc.0000269905.67284.c7}}</ref> It consists of a localised collection of [[pus|purulent]] material, usually unilateral, between the [[dura mater]] and the [[arachnoid mater]] and accounts for about 15-22% of the reported focal intracranial [[infections]]  The [[empyema]] may develop intracranially (about 95%) or in the [[spinal canal]] (about 5%), and in both cases, it constitutes a [[medical emergency|medical]] and [[surgical emergency|neurosurgical emergency]].<ref name="pmid12521560">{{cite journal| author=Greenlee JE| title=Subdural Empyema. | journal=Curr Treat Options Neurol | year= 2003 | volume= 5 | issue= 1 | pages= 13-22 | pmid=12521560 | doi= | pmc=|url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521560  }} </ref>
Subdural empyema must be differentiated from [[subdural hematoma]], [[brain abscess]], [[bacterial meningitis]], [[viral encephalitis]], [[epidural abscess]], and cerebral thrombophlebitis.


==Differential Diagnosis==
==Differential Diagnosis==

Revision as of 20:07, 1 September 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

Subdural empyema must be differentiated from subdural hematoma, brain abscess, bacterial meningitis, viral encephalitis, epidural abscess, and cerebral thrombophlebitis.

Differential Diagnosis

The clinical features presented by a patient with subdural empyema, such as: fever, headache, focal neurological signs, seizures and altered mental status, are common to other pathologic conditions: [1][2]

  • Brain abscess - an abscess in the brain caused by the inflammation and accumulation of infected material from local or remote infectious areas of the body. The infectious agent may also be introduced as a result of head trauma or neurological procedures.

These conditions may be distinguished from subdural empyema by their clinical findings, lumbar puncture results, brain imaging tests and laboratory studies.

References

  1. Agrawal, Amit; Timothy, Jake; Pandit, Lekha; Shetty, Lathika; Shetty, J.P. (2007). "A Review of Subdural Empyema and Its Management". Infectious Diseases in Clinical Practice. 15 (3): 149–153. doi:10.1097/01.idc.0000269905.67284.c7. ISSN 1056-9103.
  2. Longo, Dan L. (Dan Louis) (2012). Harrison's principles of internal medici. New York: McGraw-Hill. ISBN 978-0-07-174889-6.

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